Egypt is the most populous country in the Middle East. It serves as a bridge between the West and the Arab countries. Cigarette and water pipe smoking and medical complications of tobacco use are increasing at an alarming rate. Half of male Egyptian physicians are smokers. The overall goal of this initiative is to establish research and capacity building projects to reduce tobacco use in Egypt. We propose to carry out observational, interventional and policy research in Egypt and build capacity for smoking prevention. Specific Aims are: 1) create the Egyptian Smoking Prevention Research Institute (ESPRI) to perform smoking prevention research within the Ministry of Health and Population (MOHP) and to become a World Health Organization Collaborating Center; 2) implement epidemiological surveillance and research on tobacco use, tobacco harm and risk factors for tobacco use including studies of special relevance to Egypt, e.g. smoking water pipes and monitoring the high smoking rate among physicians; 3) conduct molecular epidemiology research to identify genetic and environmental risk factors associated with addiction and tobacco harm; 4) conduct intervention research to reduce community second-hand tobacco smoke in villages and reduce cigarette and water pipe smoking in physicians and young adults; 5) carry out policy research to study implementation, enforcement, and enactment of laws and regulations to protect the public from tobacco harm; 6) build capacity and strengthen infrastructure by long- and short-term training of health care providers, health educators, government workers, laboratory personnel and non-governmental organizations. Lasting partnerships will be established between U.S. and Egyptian investigators. Research associates will be trained on tobacco-related issues through their work on these projects. Training workshops will be conducted for MOHP staff and media groups. In addition, the formation of a tobacco control coalition will strengthen the role of non-governmental organizations as partners in tobacco control. The proposed studies will add significantly to the current knowledge base in tobacco control efforts specific to Egypt. The establishment of the ESPRI and the professional development of Egyptian investigators and Research Associates will accelerate Egypt's efforts to become tobacco free.